A Brief History of Medical Coding

Because the medical coding field is expanding so rapidly at the moment, it may seem like it’s a relatively new occupation… but this certainly isn’t the case!

Medical billing and coding have been around for decades. And just like fifty years ago, it continues to be an ever-changing field.

Believe it or not, the ICD-9 diagnosis coding system originated in 17th century England.

Statistical data was gathered through a system known as the London Bills of Mortality and arranged into numerical codes. These codes were used to measure the most frequent causes of death.

Fast-forward a few hundred years…

By 1937, this statistical analysis of the causes of death was organized into the International List of Causes of Death. Over the years, the World Health Organization (WHO) used this list more and more to assist in tracking mortality rates and international health trends.

The list was later developed into the International Classification of Diseases, which is now in its 10th edition, also known as the ICD-10-CM/PCS.

In 1977, the worldwide medical community recognized the ICD system, which then prompted the National Centers for Health Statistics (NCHS) to expand the study to include clinical information.

In other words, in 1977, the ICD system was expanded to not only include causes of death, but also clinical diagnoses such as illnesses and injuries.

Adding clinical diagnoses provided additional statistical information on basic healthcare. Now there was a way to index medical records, make medical reviews easier to complete, and provide further opportunities for medical care.

The ICD-10 version is much more specific than previous editions, for example, in ICD-9 there were only 13,000 codes and the “other” and “non-specified” codes were used for numerous diseases, conditions, and injuries. The ICD-10 has 68,000 codes, which eliminate a lot of the “other” and “non-specified” codes which help greatly with the reimbursement process.There will be a lot fewer denied claims and physicians and healthcare providers will be paid for specific services instead of generic cases.

There were numerous changes made between ICD-9 and ICD-10. Aside from the number of codes and the elimination of most of the “other” and the “non-specified” codes and the inclusion of combination codes for symptoms and diagnoses, fewer codes are needed to report and fully describe a patient’s condition. The code set has been expanded from five positions (first one alphanumeric, others numeric) to seven positions. The codes use alphanumeric characters in all positions, not just the first position as in ICD-9. When using a modifier, the codes expand to 6 or 7 positions.

So,why the Change from ICD-9 to ICD-10? The question on a lot of physicians, coders, and healthcare information specialists minds was why the change? Many of these people believed the change would only confuse everyone and make things worse; if it is not broken why fix it? What they didn’t realize is that the “system” was not only broken but dated and in need of upgrading. If hospitals, healthcare facilities, and private practice physicians were going to “stay in business” these changes were necessary and long overdue.

As medicine becomes more reliant on technology and web-based medical records, more changes are sure to take place involving medical billing and coding guidelines and the preservation and confidentiality of medical records. The Centers for Medicare and Medicaid Services and Centers for Disease Control and Prevention have already approved adding 3,651 ICD-10 hospital inpatient procedure codes and about 1,900 ICD-10 diagnosis codes for the fiscal year 2017. Implementation of the new codes will begin in October 2016.

Medical Coding is making history right now and the future of health care looks promising.